From Sprain to End-Stage Osteoarthritis: Why Earlier Intervention in Ankle Cartilage Damage Deserves More Attention

➢ Ankle cartilage damage ranges from osteochondral lesions of the talus to end-stage osteoarthritis. End-stage ankle osteoarthritis has been associated with a health burden comparable with that of major chronic diseases such as congestive heart failure and kidney disease, while predominantly affecting young and active patients.➢ Ankle osteoarthritis often has a posttraumatic nature, making it possible to study the long-term results of traumatic articular injuries and identify potential targets for early therapeutic interventions.➢ The scientific literature has been predominantly focused on outcomes after surgical treatment of osteochondral lesions of the talus or osteoarthritis. However, evidence on nonoperative treatment has been limited and methodologically weak, with evidence for early interventions (e.g., lifestyle or biologicals) even more scarce.➢ The greatest opportunity to improve long-term outcomes in ankle cartilage damage may be early recognition and early initiation of treatment.